The New Year is still wet and in diapers. Now is the traditional time for individual resolutions of good behavior for the year ahead. The Annual New Year’s Resolution Parade. There is one public health inspired promise that only Donald Trump can make. One that would benefit all of America.

As the final voting figures show conclusively, the majority of American voters did not want Trump. Too bad, so sad. The fact is that all of America has only one President at a time.

Today that President is Barack Obama. In three weeks, it will be Donald J. Trump. Trump has promised to change some things about the President’s policies and conduct.

Here’s his chance to set the proper example for all of us, and to start with himself.

Electing an American President is a time-consuming, draining and expensive process, financially, emotionally, and psychologically. It is a good thing we do it only once every four years. When we decide, America deserves to receive the benefits of calm and orderly governing for the full term of office in question.

It is true that Trump has been granted a single four-year exclusive license to lead our government, with one additional four year option entirely at voter discretion.

We spend a lot of money on the physical protection of the President: on White House security, Secret Service continuous 24-hours personal protection, communications privacy, and land and air transportation security to defend against any and all external threats to the President and his family by terrorists and deranged actors of any nationality.

The Secret Service record is quite good during the last 50 years. A number of attempts on the President have been foiled, and only a lone nut, attacking Reagan with a gun, nearly succeeded in his attack on America’s legitimate leader.

These dedicated agents do their job wonderfully under trying circumstances, protecting America’s investment in our top officials.

But there is a flip side to this equation. Each President has an individual personal duty to make sure they are mentally and physically fit, to the best of their ability, to perform their duties for the full term of their office.

We have been fortunate that no modern President has died in office since Kennedy was assassinated in 1963, and no President has had a prolonged serious illness, other than Reagan’s recovery from his vicious attacker. The closest we have come to a serious chronic medical ailment is perhaps Cheney’s history of various heart problems in a sitting Vice-President, not the President himself. Otherwise, our Presidents for more than 50 years have kept themselves in good physical shape, in conjunction with the best medical care the nation can provide, available around the clock in a heartbeat.

So ,the President has an independent serious duty to stay healthy. We know a good bit about the health status of former presidents because their terms are finished, and time has passed for any residual medical problems to be discovered and accounted for.

We don’t know much about incoming President Trump’s health status except for that laughable 5-minute dashed off letter from December 4, 2015 from his internist Dr. Bornstein (henceforth, the redoubtable Dr. B), declaring he would be the fittest President who ever served. From a medical perspective his opinion was virtually worthless, and a number of qualified physicians finally spoke up and said so.

From the New York Daily News report:

In Trump’s health letter, Bornstein, the 70-year-old mogul’s doctor since 1980, wrote that the mogul’s “physical strength and stamina are extraordinary,” and that if elected, he would be “the healthiest individual ever elected to presidency.”

That was some pretty weak propaganda tea, and eventually even Trump noticed. So he had anther go soothing concern about his health status in September 2016.

Trump had another go-round on the whole medical thing earlier last fall after a new examination, and a somewhat more detailed report from the redoubtable Dr. B of New York. Trump made a dramatic show of releasing the new medical opinion through the Dr. Oz TV show on September 14, as Trump sat for nearly an hour taking softball questions. More than a little unorthodox, but that is Trump, after all.

So we know a bit more, though Trump has still not provided a thorough medical report of the quality expected from a Board-certified internist, even up to the present day. More Trumpian smoke and mirrors.

We know Trump takes some pills, an anti-cholesterol drug, and according to the redoubtable Dr. B. Trump weighs 236 pounds and stands 6’3″ tall.

Absent the usual detailed findings of a proper medical history and report from a qualified medical specialist, perhaps the best simple indicator of a person’s underlying state of risk for many serious illness, particularly for cardiovascular disease, which is the primary killer of older men, is the Body Mass Index (BMI). This widely known tool depends on a person’s accurate height and weight.

Body Mass Index (BMI)

From the U.S. National Institutes of Health:

BMI is a useful measure of overweight and obesity. It is calculated from your height and weight. BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat. The higher your BMI, the higher your risk for certain diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers. Although BMI can be used for most men and women, it does have some limits: It may underestimate body fat in older persons and others who have lost muscle.

The body mass index (BMI) is a statistic developed by Adolphe Quetelet in the 1900’s for evaluating body mass. It is not related to gender and age. It uses the same formula for men as for women and children.

From the Wikipedia entry about BMI:

The body mass index (BMI) or Quetelet index is a value derived from the mass (weight) and height of an individual. The BMI is defined as the body mass divided by the square of the body height, and is universally expressed in units of kg/m2, resulting from mass in kilograms and height in metres.

The BMI may also be determined using a table or chart which displays BMI as a function of mass and height using contour lines or colours for different BMI categories, and which may use other units of measurement (converted to metric units for the calculation).

The BMI is an attempt to quantify the amount of tissue mass (muscle, fat, and bone) in an individual, and then categorize that person as underweight, normal weight, overweight, or obese based on that value. However, there is some debate about where on the BMI scale the dividing lines between categories should be placed. Commonly accepted BMI ranges are underweight: under 18.5 kg/m2, normal weight: 18.5 to 25, overweight: 25 to 30, obese: over 30.

For practical purposes BMI values are grouped into several classes, as follows:

<18.5 Underweight and potentially unhealthy
18.5 – 24.9 Healthy weight
25.0 – 26.9 Somewhat overweight, avoid gaining weight
27.0 – 29.9 Overweight, elevated risk of health problems
30.0 – 34.9 Class 1 Obesity, High health risk
35.0 – 39.9 Class 2 Obesity, Very high health risk
40.0+ Class 3 Obesity, Extremely high health risk

Where is Trump on the BMI Spectrum?

The redoubtable Dr. B’s report says trump is 6’3” tall. No pertinent detail is provided, such as wether that height was patient self-reported, measured by a nurse in stocking feet or shoes, etc.

We do know that Trump is not 6’3” tall at age 70. In fact ,he was never that tall, even in the full flower of vigorous youth. We know that because Trump’s official government records from his Draft Registration Card in 1964 at age 18 show a measured height of 6’2” tall, and a weight of 180 pounds.

Of course it is not unusual, for men especially, to sneak in an extra inch or two on a drivers license or employment application when no one is checking. A little white lie. American men, however, don’t voluntarily report being shorter than they are, under nearly all normal circumstances.

Besides look at any recent pictures of Trump standing near son-in-law Jared Kushner. Kushner is 6’3” tall and he clearly tops Trump today by an inch or two.

The other reason we know Trump can’t be 6’3” is natural age-related drooping. After 70 years of life events, even in the relatively protected and atraumatic office work environment Trump has always labored in, the human spine’s 23 intervertebral discs begin to dry out (desiccate) and lose height over time. Loss of disc height translated into measurable loss of stature (shorter height). The average American male loses a bit more than 1 inch in height by age 70. This strongly suggests that Trump’s real height today is actually a bit less than 6’1”, which makes the BMI index results for him even worse than our generous assumptions.

Another adverse factor is the effect of a so called Dowager’s hump, named for its most pronounce effects in women, but affecting men as well. Take a look at these two recent news photographs of Trump, from the right and left profile views, taken in February 2016 in New Hampshire and a couple week later in Houston. Trump is beginning to show an evident loss of normal thoracic spinal curvature and position. Technically this is called hyperkyphosis. What it means in everyday terms is that Trump’s height today is less than it was when he was a full grown young man at his peak for two reasons.

For practical purposes, we will assign Trump full marks for his youthful height of 6’2” or 74 inches, ignoring the inevitable effects of aging and photographic evidence of his vertical height decline for purposes of our BMI comparisons. This is done in order to be overgenerous and more than fair to the man, recalling his extreme sensitivity with respect to unflattering facts, objective though they may be.

The other critical factor in BMI determination is the subject’s weight. The redoubtable Dr. B of New York pegs Trump’s current weight at 236 pounds. We don’t know if that weight was measured on a calibrated scale, while patient was dressed or undressed, or patient self reported.

Honestly, this weight data is another possible fib situation that Americans often indulge in. Take the typical drivers license data. Men are weight vain too, particularly as they age and their general physical fitness and muscle mass declines.

Here again we have some photographic evidence which suggests an under recording of Trump’s actual weight. Look at his ample midriff and posterior in this three peat picture taken while Trump was playing golf. Examine his cheeks and jowls in other face on pictures, and it seems obvious Trump is well-fed and over nourished.

There is one more suggestive piece of data about Trump weight status. In Dr. B’s first letter of December 2015, he does comment that Trump had lost at least 15 pounds in the last year. This also would put Trump in the approximately 250 pound club class within the last 2 years, according to his own personal physician.

Despite the preponderance of evidence, since it is not certain not beyond all reasonable doubt, let us accept Trump’s current accurate weight as only 236 pounds. As a non-expert, but quite large man myself, I would agree with a number of sports trainers and exercise physiologists who have eyeballed recent pictures of Trump, and estimate his actual weight at a good 250 pounds or better. For another time.

Using the standard scientific formula for determination of BMI as given by the calculator app on the National Institutes of Health website, Trump’s BMI is a impressively convincing score of 30.3. That is using the most flattering possible numbers for Trump’s biological parameters of height and weight.

Check your own BMI score at the NIH website, as you follow along with this argument.

For our purposes there are three relevant ranges of BMI: Normal (18.5-24.9); Overweight (25-29.9); and Obese (>30), So, Trump is, if we use optimistic assumptions, borderline obese, and otherwise certainly at the upper extreme end of overweight.

A high BMI predicts adverse health risks and poorer health outcomes from a large variety of medical illness, especially in older people, and in those with sustained elevation of the BMI index. Trump’s BMI is a red flag warning in any ordinary person. It is even more serious in a person who has a high stress job, much less that of the President of the United States, who holds his hand on the nuclear trigger, among other things that tighten the gut.

Previous Presidential Office Holders

So, where does Trump fit in the Presidential Scale of BMI in our nation’s200-plus year history. Trump is a very competitive guy, and always wants to finish first. He doesn’t make the grade here, either in height or weight, compared to the 44 men who came before him in office. But, he is in the top 10% in each category individually.

On the tallness scale the clear winner is Abraham Lincoln at 6’4”, followed by Lyndon Johnson at 6’ 3 ½”. Next in line is Thomas Jefferson at 6’ 2½”. At Trump’s gift height of 6’2” for our purposes, he winds up in a six-way tie (George Washington, Chester Arthur, Franklin Roosevelt, George H W Bush, and Bill Clinton). Eighteen of our 45 Presidents have been at least 6 feet tall.

On the weight only scale, there is a single Presidential whale, William Howard Taft (1908-1912), who weighed in at more than 320 pounds. Next in line was Grover Cleveland (1885-1889, 1893-1897) at about 260 pounds. Trump is in clear possession of third place at 236, pounds the most slender of his possible weight configurations

So, Trump is not number one in two additional Presidential Characteristic lists.

But the critical thing about BMI is not either component measurement taken by itself, but their synergistic combination of height and weight. Where does Trump land on this scale? I have prepared a chart of the Worst US Presidents by BMI and the Last 12 Men fortunate enough to hold this precious office for us.

In the overall BMI sweepstakes contest Trump is far and away the third worst performer in U.S. history. He is not merely overweight, he meets the strict clinical criteria to be diagnosed as obese, with all the health risks that label entails. He lags in his unfortunate score behind only William Howard Taft from 100 years ago, and Grover Cleveland from 125 years ago.

Among all Presidents, of both parties, who have held office in the 70 years (1946) since he was born, Trump has the worst rating. No President in that entire period weighed more than 200 pounds. This despite the fact that 8 out of 12 (67%) of Trump’s immediate predecessors were more than 6 feet tall. None of the easy big bones excuse baloney.

Lyndon Johnson hit the magic 200 pound threshold, but he was taller than Trump. In complete fairness to our President-elect, Bill Clinton lost 20 pounds while in office to get to 196 pounds mid-term, by following his White House doctor’s sound medical advice. But Clinton did start out at a chubby 216 pounds.

The only modern Presidents who exceeded the BMI Normal healthy weight criteria were Bush II (26.6), Ford (26.4), and Clinton briefly before he lost weight (25.2). None of them were more than 1.5 BMI points off the mark. Trump has blown through the entire overweight range, and rests optimistically in the obese BMI Red Zone.

At age 70, Trump has an elevated body fat percentage by objective scientific criteria. His BMI is almost 4-points worse than the next worst score in modern times.

BMI is not an inherited gene thing. It is mainly the result of a lifetime of cumulative voluntary choices. It is under the control of a person’s free will. It is a complex function of nutrition, exercise, work habits, eating habits, self discipline, and psychological factors. It is medically treatable, and can be altered for the better, through sustained personal effort and commitment.

What Has Trump’s BMI Got to Do with America’s National Interests?

America is about to sign a four year contract with Trump to be President, with an option to renew for four more years. We have a contract. Everybody has to sign. It is no verbal handshake, wink and a nod type deal.

Trump gets the keys to the world’s most exclusive personal address with full amenities and 24-hour premium concierge and room service, grander even than Trump Tower and Mar-a-Lago combined. He gets a four year no-cut contract as CEO of the greatest organization in the Western World, with thousands of times more resources and power than all his businesses combined could ever dream of having (trillions of dollars compared to an mere puffed up $10 billion). Trump gets a lifetime pension, office expenses, and Secret Service personal protection, all on the U.S> taxpayer’s dime. And a publicity platform unrivalled in scope and influence by any celebrity in the known Universe.

A very sweet gig indeed.

What does America get from this contract? We get 100% of Trump’s effort and energy, and whatever wisdom he can muster. We get the solemn promise there will be no part-time personal business distractions to deflect his complete devotion to his job for America. Finally, we get his dedication to do everything he can to advance and preserve his own health in order to secure our nations’ multi-million dollar annual investment in his personal welfare and well-being, and the security protection we provide for his family, at no cost to him.

America will invest tens of millions of dollars to providing aid and comfort to ensure Trump’s personal well being, including his health, from external threats and risks of all kinds.

What Trump owes us back in a small measure of return for his blessings from the Electoral College is a parallel serious personal commitment to preserve his own health. If not for his sake, or for that of his wife and young son, then certainly and most importantly for the nation which has gifted him temporary custody of in his leadership.

What Can Trump Do About His Own BMI Health Situation?

Trump is obese, flabby, and out of shape. He has lousy dietary habits. He is already suffering from at least one adverse health effect related to his obesity. He needs proper medical advice and treatment to lose 35 pounds to approach the normal weight range for a man of his size.

Calling the redoubtable Dr. B of New York! Your patient needs your best advice and medical help, not a five-minute quickie opinion. We can all hope that the redoubtable Dr. B is far too busy with his New York medical practice to move to Washington, and that the next White House doctor will be a better advocate and medical advisor for President Trump, on behalf of the American people, than Trump’s current medical staff has been.

In his astonishing Dr. Oz interview in September Trump smiled and blamed his bad eating habits on his busy travel schedule. Elsewhere, he had offered the notion that fast food chains provide consistency in food quality he can’t find elsewhere, and that Trump doesn’t want his food tampered with.

These are now all specious arguments. Trump may rest assured that the White House chef and food staff devoted to him are all highly skilled and extremely carefully vetted, and the food panty contents are properly approved, sampled and securely stored. The staff and food contents are secure and protected by the Secret Service 24-hours every day. No more excuses in that regard.

Trump has not made a case, so far as I can tell, that KFC fried chicken and McDonalds burgers and fries belong as a regular part of a healthy balanced life-giving diet.

Trump Needs to Dump Regular Fast Food Consumption, despite his fat loving taste bud craving preferences.

As a private citizen until January 2017, Trump’s dietary habits and indiscretions are a private matter. We may all wish he would do better for himself, but he is free to choose his poison. For the next four years however, Trump is not a private citizen. His work product and personal health are no longer solely his own concern, and that of his wife and children. Preserving his health is a matter of public business. He can not properly fulfill his contract with America, and still do whatever he likes health-risk wise. There are constraints.

It’s tough to bear, but the constraints go with the fabulous perks, which Trump is all too ready to smorgasbord and chow down on. A little discipline at the dinner table and for snack time.

Trump ought to make his first annual New Year’s Resolution on Behalf of the American People to pledge to do his fair share to keep himself healthy and lose weight, according to sound medical advice.

Final Note

Trump’s obesity is not a unique or isolated problem. Tens of millions of Americans know all too well the pressures and feel the pain in their own families. Few have the resources or obligation to get help that Trump now has.

It is ironic that Trump’s staff has confirmed he has a definite aesthetic vibe in mind for his businesses to present to the public; and that he expects to carry over to his Administration. The public face of the Trump Organization’s secretaries and assistants staff are notably and invariably slender and attractive, many with long legs well clothed and displayed. It has been said that former diplomat John Bolton lost his chance to be Secretary of State in part because he sports what Trump considers to be an unkempt, bushy mustache. Trump himself did not confirm that report. Neither did he deny it. Christie is nowhere to be found in the Administration appointment mix.

Applying the obvious superficial physical standard to the man himself, Trump would be passed over for a highly responsible position in his own outfit. I guess he must use a magic slimming mirror to contemplate his own image in review.

During his Oz interview, Trump humbly explained he has always had something of a mild weight problem. The typical Trump Exaggeration Syndrome (TES) rears its inconvenient head again. In his signed Government Draft Registration card from 1964, Trump is listed as being 6’ 2” tall and weighing 180 pounds.

That was the real Trump in 1964. Amazingly enough, that works out to a perfectly fine BMI of 23.1 (just as good as President Obama’s current BMI at age 55). Trump now remembers a fatty boy Trump in his twenties where none actually existed, perhaps in order to salve his guilty conscience. He just can’t take ownership of the most modest personal flaw, whatever embellishment he must concoct to duck it.

That is a dangerous trait in a President who needs to see straight, think straight, talk straight, and act straight on our nation’s behalf.

Trump told Oz he would like to lose 15-20 pounds. That is an undershoot (50%,) of defensive proportions Trump needs to lose 35-40 pounds to reach the upper limits od a normal weight range for his height. Trump’s ideal weight is 190-200 pounds.

The best medical advice is that an adult should gain no more than about 10-15 pounds after age 18. That sound advice would put Trump’s healthy goal at 190-200 pounds for his age. Amazing how that science-type stuff actually works, isn’t it?

The White House doctor should provide sound guidance and treatment for our next President pronto. President Trump needs to grumble and take his medicine for the sake of the American people, and their significant investment, financial, personal, and psychological in his success.

It benefits no one, friends and enemies alike, should Trump continue to act carelessly (particularly in respect to unhealthy dietary habits) and then suffer a stroke or myocardial event. We don’t need a President medically laid up and functioning at less than 100% of his capacity due to preventable causes, identified well ahead of time.

We certainly don’t need the confusion, chaos, and disruption in our national affairs that would inevitably follow, despite the Constitutional and legal procedures in place to mitigate the damages. These safeguards are a pale and emergency substitute for the real thing.

America deserves better from its one and only Commander-in-Chief.

Most of us tend to tread lightly around weight issues, especially for those close to us, since so many are affected. That concern may not extend so widely to strangers and others. Trump’s own well documented history of distain and ridicule directed at heavy people are proof enough.

Trump has already fairly earned, by word and deed, the appellation of relatively friendlier terms chubby, chunky, and portly. If he sticks to his stubborn ways, he will soon venture into Blimpy and Fatso territory prevalent when we were youngsters in the 50’s and 60’s. This is Trump’s natural idiom. Not nice, but to the point. Trump speak vectoring back to home base.

It would be sad for a President to face such recurrent distractions from his work. It would be sadder still for America to have to endure a preventable health crisis in a sitting President, through his own negligence and irresponsible behavior.

We could all use a win-win here.

Eat less, move more, eat better stuff, see the doctor and follow expert advice.

Mr. Trump: KFC and McDonalds will do just fine without your regular consumer consumption contributions to their profit structure. Honest. Trust me on this point, sir.



*Bariatrics:

Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.

The term bariatrics was coined around 1965, from the Greek root bar- (“weight” as in barometer), suffix -iatr (“treatment,” as in pediatrics), and suffix -ic (“pertaining to”). The field encompasses dieting, exercise and behavioral therapy approaches to weight loss, as well as pharmacotherapy and surgery. The term is also used in the medical field as somewhat of a euphemism to refer to people of larger sizes without regard to their participation in any treatment specific to weight loss, such as medical supply catalogs featuring larger hospital gowns and hospital beds referred to as “bariatric.”

Overweight and obesity are rising medical problems. There are many detrimental health effects of obesity: Individuals with a BMI (Body Mass Index) exceeding a healthy range have a much greater risk of medical issues. These include heart disease, diabetes mellitus, many types of cancer, asthma, obstructive sleep apnea, and chronic musculoskeletal problems. There is also a focus on the correlation between obesity and mortality.

Overweight and obese people, including children, may find it difficult to lose weight on their own. It is common for dieters to have tried fad diets only to find that they gain weight, or return to their original weight, after ceasing the diet. Some improvement in patient psychological health is noted after bariatric surgery.